Document Title:- Document No :- CIPL/ HSE/ 005/ 13
Rev:- 0
Scaffolding Safety Inspection Checklist Date :-
Site :- Date :-
Location :- Forman/Supervisor :-
Sl. No. Activities Observation Measures if not ok
Ground Surfaces
1 Ground level , no soft spot
2 Footing timber level adequately supported
3 No Unauthorized Entry
Scaffolds
1 Base plate level
2 Spindle jack vertical
3 Standard Plumb (vertical tubes) , no damage
4 Ledgers level (horizontal tubes), no damage
5 Diagonal bracing, check secure and non missing
6 Lock pin in place and secure
7 Support from permanent structure
Ladders
1 Check placed on level ground
2 Position at an angle of 1:4
3 Adequately secured
4 No damage, check welds
5 Extent 4 rungs above stepping off point
6 Uniform and proper spacing of rung
Working Platform
1 Should not be less than 600 mm wide
2 Guard rails adequate check
i) Top rail at least 910 mm height
ii) No gap greater than 470 mm
3 Boards free of defects check
i) No gaps
ii) Adequate supports
iii) No risk of trips
iv) Properly secured / tied
PPE
1 Helmet and footwear worn
2 Safety harnesses as required and secured above shoulder level
3 Use of safety belt while working at height
4 Safety Goggles during welding / gas cutting / Grinding etc.
5 Condition / Maintenance of safety appliances
6 Use of body guards, gloves etc.
Document Title:- Document No :- CIPL / HSE/ 005/ 13
Rev:- 0
Scaffolding Safety Inspection Checklist Date :-
Page 2 of 2
Means of Access
1 Platform , toe board and railings
2 Scaffoldings – its condition and maintenance
3 Staircase and railing
4 Ladder & fixing
5 Safe access to and from means of access
Housekeeping
1 Material stacking & storing
2 Working / moving area clean
3 Access / Main Approach / Passages free form obstacles
4 Cordoning / covering of pit , vat, machine foundation etc.
5 Displaying of Red Flags / Tape / light
6 Removal of unwanted materials like excavated earth debris etc.
Prepared By :- Verified By :-
Name:- Name :
Signature :- Signature